SPM 100 Clinical Skills Lab 7 Emergency Assessment

SPM 100 Clinical Skills Lab 7 Emergency Assessment Daryl P. Lofaso, M. Ed, RRT

Initial Assessment Guide n Primary Assessment ¡ Observational Assessment n n n Appearance, WOB, and Circulation Intervention to any life-threatening condition Secondary Assessment (Serial) ¡ ¡ Vital Signs GCS

Primary Assessment n n A = Airway / C-spine immobilization B = Breathing C = Circulation D = Disability or Neurologic Status

Secondary Assessment n n n E = Exposure and environmental control to prevent heat loss F = Full set of vital signs, wt. G = Give comfort measures H = Head-to-toe assessment and History (Hx) I = Inspect posterior surfaces

Triage Assessment n Emergent n Urgent n Non-urgent

Emergent n n n Airway and Breathing Difficulties Cardiac Arrest C-spine compromise Seizure states Life or limb-threatening condition

Emergent (continued) n Severe medical problems (Overdose, poisoning, DM complications) n Obvious multiple injuries n Excessive high temperature (> 105 o. F or 40. 5 o. C) n n Cardiac CP Neurological Deficit – Stroke (CVA)

Urgent n n n n Chest Pain (Non-Cardiac) Burns ↓ LOC Persistent nausea, vomiting, or diarrhea Severe pain Temperature (102 -105 o. F or 39 o-40. 5 o. C) Delay of up to 2 hrs will not compromise life or limb

Non-Urgent n n n Chronic backache Moderate headache Minor Fx or other injuries Obviously dead on arrival (DOA) Stable illness or injury, wait > than 2 hrs without an increased risk of morbidity or mortality

Patient’s Condition n Stable – VS within normal limits. Pt conscious & comfortable. Guarded – VS within normal limits. Pt has some discomfort. Unstable – VS outside of normal limits. Major complications. Prognosis guarded.

Universal Precautions n n All Patients are potentially infectious. Good Handwashing is the key to reducing nosocomial infections Wash before and after patient contact Wear a mask, eye protection, gloves and gown when needed

3 Types of Precautions n Airborne n Droplet n Contact

Pathogens Requiring Airborne Precautions n Tuberculosis n Measles (Rubeola) n Varicella (Chickenpox)

Airborne Precautions Management Place patient in an isolation room with negative pressure n Keep door closed n Wear N-95 mask n

Pathogens Requiring Contact Precautions n Multi-drug resistance bacteria (e. g. , VRE – Vancomycin Resistant Enterococci, MRSA - Methicillin Resistant Staphylococcus Aureus) RSV - Respiratory Syncytial Virus n Clostridium difficile n Scabies n